455P - Metastatic Neuroendocrine Neoplasia (mNEN) Treatments in over 70 Years (y) Old Patients: A Retrospective Outcome Analysis

Date 10 September 2017
Event ESMO 2017 Congress
Session Poster display session
Topics Neuroendocrine Cancers
Geriatric Oncology
Endocrine Cancers
Presenter Alberto Bongiovanni
Citation Annals of Oncology (2017) 28 (suppl_5): v142-v157. 10.1093/annonc/mdx368
Authors A. Bongiovanni1, F. Foca1, F. Recine1, V. Fausti1, N. Riva1, E. Setola1, M. Faedi1, A. Ianniello1, F. Pieri2, R. Galassi3, D. Cavaliere4, A. Gardini4, A. Tartaglia5, V. Lunedei6, L. Mercatali1, D. Amadori1, T. Ibrahim1
  • 1Osteoncology And Rare Tumors Center, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), 47014 - Meldola/IT
  • 2Pathology Department, Morgagni Pierantoni Hospital, 47121 - forli/IT
  • 3Nuclear Medicine Operative Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), 47014 - Meldola/IT
  • 4Surgery Department, Morgagni Pierantoni Hospital, 47121 - forli/IT
  • 5Endocrinology Department, Morgagni Pierantoni Hospital, 47121 - forli/IT
  • 6Gastroenterology Department, Morgagni Pierantoni Hospital, 47121 - forli/IT

Abstract

Background

NEN incidence increases with age. Elderly population is usually underestimated in clinical trials due to presence of co-morbidities and low performance status (PS) and thus prognosis’ informations are lacking. Our study aims to analyze the outcome in a retrospective cohort of elderly metastatic NEN patients (pts) who underwent different treatments.

Methods

From June 2006 to march 2016 we collected data from pts ≥70 y with mNEN. Comorbidities were summarized by the Charlson Comorbidity Index (CCI). Kaplan-Meier method was used to estimate overall survival (OS), Cox’s proportional hazard model to assess the impact of known prognostic factors. Adjusted hazard ratios (HR) were calculated with 95% confidence interval (95% CI).

Results

We identified 145 pts ≥70 y with mNEN. Pts characteristics were resumed in the table. Median follow up was 72.3 (53.2-85.1) months. First Line treatment was: somatostatin analog (SSA) in 79 pts, peptide radionuclide therapy (PRRT) in 23, chemotherapy (CHT) in 36 pts. Seven pts didn’t receive first line treatment and 102 pts received more than 1 line treatment. PS ECOG and FDG PET results were identified as independent prognostic factors for OS assessed by a multivariate Cox regression model, with a higher risk for patients with PS ECOG ≥0 and with positive FDG PET, while age at diagnosis showed a hazard ratio of 1.10 (95%CI:0.99-1.26). Median OS was 5.1y (3.4-6.6). No difference in mOS were seen according to CCI. G1/G2 NEN pts who underwent PRRT as first line had a mOS of 6.5 y (3.3-NE), SSA 5.7 y (4.2-7) and CHT 5.9 y (0.4-NE) respectevely. G3NEN pts treated with CHT had a mOS of 1.5 y (1.0-2.5).Table:

455P

Pts characteristicsN (%)
Male86 (59.3)
Female59 (40.7)
Age at diagnosis
Median (range)74 (70-87)
70-74 years89 (61.4)
75-79 years40 (27.6)
80+ years16 (11.0)
PS ECOG
059 (45.7)
160 (46.5)
≥210 (7.8)
Unknown(UK)16
CCI
057 (41.0)
152 (37.4)
219 (13.7)
≥311 (7.9)
UK6
Syndromic
Yes42 (29.4)
No101 (70.6)
UK2
Grading
G133 (26.2)
G262 (49.2)
G331 (24.6)
UK19
Metastatic sites
Hepatic58 (40.0)
Extrahepatic29 (20.0)
Both58 (40.0)

Conclusions

Our results suggest a positive impact of various treatment on OS in mNEN elderly patients and the prognostic value of FDG PET and PS ECOG. Prospective clinical trial are needed to confirm our retrospective data.

Clinical trial identification

Legal entity responsible for the study

Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.) IRCCS

Funding

None

Disclosure

All authors have declared no conflicts of interest.